Research toward wider use
Dr. Matulonis is conducting research on ways to ease some of the side effects of IP therapy. One trial aims to determine whether the less-toxic carboplatin can be substituted for cisplatin. At this point, it is not clear whether the two drugs are equally effective when administered intraperitoneally. If carboplatin were shown to be just as effective, IP therapy would be easier to tolerate and might also allow it to be done as an entirely outpatient procedure.
Even with the blessing of the National Cancer Institute, physicians and hospitals are far from unanimous in adopting IP therapy for advanced ovarian cancer, and this is true for both community and teaching hospitals, says Dr. Matulonis. She's carrying out research on the reasons that some health providers aren't offering the therapy, and how the barriers might be overcome.
Based on conversations with patients, Dr. Matulonis believes that some women are being deterred by the notion that the quality of life during treatment with IP chemotherapy is significantly worse than with standard treatment, as was described in the report of the clinical trials. But those data were gleaned from patients treated a decade ago, and supportive care has improved a lot since then, she says.
"That's why I want to repeat the quality-of-life study," Dr. Matulonis explains. "The perception of side effects is very subjective —and with today's medications the quality of life may not be poorer after all."
IP therapy improves both progression-free (time until disease progresses) and median overall survival in advanced ovarian cancer.
